Cost Analysis of Target Lesion Revascularisation in Patients With Femoropopliteal In Stent Re-Stenosis or Occlusion: The COSTLY-TLR Study.

Autor: Saratzis A; Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. Electronic address: http://www.twitter.com/a_saratzis., Torsello GB; Institute for Vascular Research, St Franziskus Hospital, Münster, Germany., Cardona-Gloria Y; Institute for Vascular Research, St Franziskus Hospital, Münster, Germany., Van Herzeele I; Department of Thoracic and Vascular Surgery, Ghent University, Ghent, Belgium., Messeder SJ; Department of Cardiovascular Sciences, University of Leicester, Leicester, UK., Zayed H; Department of Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK., Torsello GF; Department of Interventional Radiology, Charité Universitätsmedizin, Berlin, Germany., Chisci E; Department of Vascular Surgery, San Giovanni di Dio Hospital, Florence, Italy., Isernia G; Department of Vascular Surgery, Azienda Ospedaliera di Perugia, Perugia, Italy., D'Oria M; Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste, ASUGI, Trieste, Italy., Stavroulakis K; Department of Vascular Surgery and Endovascular Surgery Ludwig-Maximilians University Hospital Munich, Munich, Germany. Electronic address: stavroulakis.konstantinos@yahoo.gr.
Jazyk: angličtina
Zdroj: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery [Eur J Vasc Endovasc Surg] 2024 Jul; Vol. 68 (1), pp. 100-107. Date of Electronic Publication: 2024 Feb 07.
DOI: 10.1016/j.ejvs.2024.02.001
Abstrakt: Objective: To report the cost of target lesion revascularisation procedures (TLR) for femoropopliteal peripheral artery disease (PAD) following stenting, from a healthcare payer's perspective.
Methods: European multicentre study involving consecutive patients requiring femoropopliteal TLR (January 2017 - December 2021). The primary outcome was overall cost (euros) associated with a TLR procedure from presentation to discharge. Exact costs per constituent, clinical characteristics, and early outcomes were reported.
Results: This study included 482 TLR procedures (retrospectively, 13 hospitals, six countries): 56% were female, mean age was 75 ± 2 years, 61% were Rutherford class 5 or 6, 67% had Tosaka class 3 disease, and 16% had common femoral or iliac involvement. A total of 52% were hybrid procedures and 6% involved open surgery only. Technical success was 70%, 30 day mortality rate was 1%, and the 30 day major amputation rate was 4%. Most costs were for operating time during the TLR (healthcare professionals' salaries, indirect and estate costs), with a mean of: €21 917 ± €2 110 for all procedures; €23 337 ± €8 920 for open procedures; €12 903 ± €3 108 for endovascular procedures; and €22 806 ± €3 977 for hybrid procedures. In a regression analysis, procedure duration was the main parameter associated with higher overall TLR costs (coefficient, 2.77; standard error, 0.88; p < .001). The mean cost per operating minute of TLR (indirect, estate costs, all salaried staff present included) was €177 and the mean cost per night stay in hospital (outside intensive care unit) was €356. The mean cost per overnight intensive care unit stay (minimum of 8 hours per night) was €1 193.
Conclusion: The main driver of the considerable peri-procedure costs associated with femoropopliteal TLR was procedure time.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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